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gonorrhea

 
(gŏn'ə-rē'ə) pronunciation
n.
A sexually transmitted disease caused by gonococcal bacteria that affects the mucous membrane chiefly of the genital and urinary tracts and is characterized by an acute purulent discharge and painful or difficult urination, though women often have no symptoms.

[Greek gonorrhoia, flow of seed (from the mistaken belief that the discharge contained semen) : gono-, gono- + -rhoia, -rrhea.]

gonorrheal gon'or·rhe'al or gon'or·rhe'ic adj.

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Sexually transmitted disease. It is characterized by genitourinary inflammation, caused by the bacterium Neisseria gonorrhoeae (gonococcus). Symptoms in men include burning on urination, discharge of pus, and, with deeper infection, frequent urination, sometimes with blood. Women may have mild vaginal discharge and burning, but there is usually no sign until a sex partner is infected or complications — sometimes serious — arise from its spread beyond the cervix. If spontaneous recovery does not occur, it may cause sterility in both sexes but is rarely fatal. Gonorrhea is common worldwide. Penicillin, generally a successful treatment, reduced its incidence, but resistant strains are increasingly found. Many cases are not reported. Penicillin may also mask coexisting syphilis (since the dose to cure gonorrhea does not cure syphilis).

For more information on gonorrhea, visit Britannica.com.

A common sexually transmitted disease caused by the bacterium Neisseria gonorrhoeae. Humans are the only natural hosts for N. gonorrhoeae, which directly infects the epithelium of the mucous membranes of the human genital tract, pharynx, rectum, or conjunctiva. Local epithelial cell destruction usually occurs, but the organisms may spread to adjacent organs or disseminate via the bloodstream. In women, local complications include inflammation of the uterine lining (endometritis), inflammation of the fallopian tube (salpingitis), inflammation of the abdominal wall (peritonitis), and inflammation of Bartholin's glands (bartholinitis); in men, periurethral abscess and inflammation of a duct connected to the testes (epididymitis). Systemic manifestations such as arthritis or dermatitis may develop, and rarely endocarditis or meningitis.

Women are disproportionately affected by the complications of gonorrhea. Acute pelvic inflammatory disease and salpingitis, the most serious complications of gonorrhea, result in ectopic pregnancy and infertility. Gonococcal infection during pregnancy may also predispose women to premature rupture of membranes, delivery in less than full term, and postpartum endometritis. During childbirth, the gonococcus may infect the conjunctiva of the infant and result in the infection ophthalmia neonatorum. This infection is a serious complication that remains common in less developed countries and can lead to permanent damage to the eye and blindness. See also Infertility; Reproductive system disorders.

Gonorrhea continues to be the most commonly reported communicable disease in the United States, although incidence has declined since 1984. Risk factors that may influence the probability of infection include number of sexual partners, lack of barrier contraceptives, and young age.

Gonorrhea is an infection spread by physical contact with the mucosal surfaces of an infected person, usually a sexual partner. The risk of infection depends on the anatomic site, the amount of substance containing bacteria, and the number of exposures. Variations in host susceptibility have not been well defined. In a small but significant proportion of infections, there are no symptoms. These individuals are important in the epidemiology of this disease because gonorrhea is usually spread by carriers who have no symptoms or have ignored symptoms.

Control of gonorrhea depends on early diagnosis, effective treatment, and identification of asymptomatic individuals. The last has been accomplished, in part, through screening programs. However, complete control has not been possible because of the emergence and spread of strains that are resistant to less-expensive antimicrobial treatments such as penicillin and tetracycline.

There is no evidence that infected individuals develop long-lasting immunity to reinfection, and vaccination is not available. Thus, the prevention of gonorrhea relies on behavior modification and risk reduction, use of appropriate screening and diagnostic tests, routine use of highly effective antibiotics, early identification and treatment of sexual partners of individuals with gonorrhea, and the appropriate use of barrier methods such as condoms.

An increasing proportion of infections are due to antibiotic-resistant strains of N. gonorrhoeae. Chromosomally mediated resistance to multiple antibiotics as well as plasmid-mediated resistance to beta-lactam antibiotics and tetracycline occurs in strains from both developed and developing countries. Nevertheless, infections can be effectively treated with third-generation cephalosporins (for example, ceftriaxone) or fluoroquinolones (for example, ciprofloxacin or ofloxacin). See also Sexually transmitted diseases.


Gonorrhea is a sexually transmitted disease (STD) caused by Neisseria gonorrhoeae, a bacterium. Gonorrhea is spread through sexual contact (vaginal, oral, or anal). The organism can grow easily in mucous membranes of the body, including the cervix, uterus, and fallopian tubes in women, and the urethra, mouth, throat, and rectum in women and men. It can also invade the conjunctiva (e.g., during childbirth). Each year approximately 650,000 persons in the United States get gonorrhea. Approximately 75 percent of gonorrhea cases are found in persons age fifteen to twenty-nine years. About 50 percent of men have some initial symptoms, typically a burning sensation when urinating and a discharge from the penis. Many infected women are asymptomatic or have only mild symptoms. Initial symptoms include a painful or burning sensation when urinating and a vaginal discharge that is yellow or bloody. Untreated gonorrhea in women can develop into pelvic inflammatory disease (PID), which can cause infertility or increase the future risk of ectopic pregnancy. An infected pregnant woman can transmit the infection to her newborn during vaginal delivery.

N. gonorrhoeae in the male or female genital tract can be diagnosed in a laboratory using a urine specimen. Many of the currently used antibiotics can successfully cure gonorrhea. Persons who engage in sexual behaviors that place them at risk of STDs should use latex or polyurethane condoms every time they have sex, limit the number of sex partners, and not go back and forth between partners. All young, sexually active, nonmonogamous persons who do not use condoms every time they have sex should consider being screened for gonorrhea yearly. Infected persons should notify all sex partners so they can receive treatment.

(SEE ALSO: Sexually Transmitted Diseases)

Bibliography

Centers for Disease Control and Prevention (1998). "1998 Guidelines for Treatment of Sexually Transmitted Diseases." Morbidity and Mortality Weekly Report 47(RR-1):59–70.

Hook, E. W., III, and Handsfield, H. H. (1999). "Gonococcal Infections in the Adult." In Sexually Transmitted Diseases, 3rd edition, eds. K. Holmes, P. Mardh, P. Sparling et al. New York: McGraw-Hill.

— ALLISON L. GREENSPAN; JOEL R. GREENSPAN



Columbia Encyclopedia:

gonorrhea

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gonorrhea (gŏnərē'ə), common infectious disease caused by a bacterium (Neisseria gonorrhoeae), involving chiefly the mucous membranes of the genitourinary tract. It may occasionally spread to membranes in other parts of the body, especially those of the joints and the eyes. Since the principal mode of transmission is sexual contact, gonorrhea is classified as a sexually transmitted disease. Gonorrheal conjunctivitis was once a prominent cause of blindness in the newborn, the infection being transmitted during delivery. Routine use of silver nitrate solution in the eyes of every infant at birth has largely overcome this problem.

The usual site of infection in women is the cervix. From there it can spread to the uterus and fallopian tubes and cause pelvic inflammatory disease, ectopic pregnancy, or infertility. Other complications, in both sexes, include infection of the joints, heart valves, and brain. Women are often asymptomatic, but may have a vaginal discharge or burning sensation on urination; men may have a discharge from the penis and pain on urination. Examination of the discharge reveals the presence of the bacteria. In most cases, the disease can be cured by adequate treatment with a cephalosporin antibiotic such as cefixime or ceftriaxone. Failure of treatment is usually due to resistant strains (see drug resistance); gonorrhea is now resistant to many antibiotics formerly used to cure it. Prior infection does not confer resistance and reinfection is common.


(gon-uh-ree-uh)

An acute and sexually transmitted disease, caused by bacteria that invade the mucous membranes of the genitals and urinary tract. In women, the disease can also spread to the cervix, fallopian tubes, and ovaries, leading to chronic pelvic pain or infertility. In both sexes, the disease can spread to the joints and skin (or, more rarely, the heart or brain) if left untreated. The disease can be treated with antibiotics.


n

A sexually transmitted disease of the genitourinary tract which is spread by direct contact with an infected person or fluids containing the infectious microorganism. The disease may also affect the conjunctiva, oral tissue, and other tissues and organ systems.

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categories related to 'gonorrhea'

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For a list of words related to gonorrhea, see:
  • Diseases and Infestations - gonorrhea: sexually transmitted bacterial disease that affects mucous membranes in genital tract, pharynx, or rectum
  • Anatomy and Physiology of Sex - gonorrhea: infectious venereal disease characterized by inflammation of and discharge from mucous membrane


  See crossword solutions for the clue Gonorrhoea.
Gonorrhea
Classification and external resources

During WWII, the US government used posters to warn servicemen about the dangers of gonorrhea and other sexually transmitted infections.
ICD-10 A54
ICD-9 098
MedlinePlus 007267
eMedicine article/782913
MeSH D006069

Gonorrhea (also colloquially known as the clap[1]) is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The usual symptoms in men are burning with urination and penile discharge. Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain. In both men and women if gonorrhea is left untreated, it may spread locally causing epididymitis or pelvic inflammatory disease or throughout the body, affecting joints and heart valves.

Treatment is commonly with ceftriaxone as antibiotic resistance has developed to many previously used medications.

In 2011, there were reports of some strains of gonorrhea showing resistance to ceftriaxone.[2]

Contents

Signs and symptoms

Half of women with gonorrhea are asymptomatic while others have vaginal discharge, lower abdominal pain or pain with intercourse.[3] Most men who are infected have symptoms such as urethritis associated with burning with urination and discharge from the penis.[3]

The incubation period is 2 to 30[4] days with most symptoms occurring between 4–6 days after being infected.

Cause

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae.[3] The infection is transmitted from one person to another through vaginal, oral, or anal sex.[3] Men have a 20% risk of getting the infection from a single act of vaginal intercourse with an infected woman. The risk for men who have sex with men is higher.[5] Women have a 60–80% risk of getting the infection from a single act of vaginal intercourse with an infected man.[6] A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as ophthalmia neonatorum.[3] It cannot be spread by toilets or bathrooms.[7]

Diagnosis

Traditionally, gonorrhea was diagnosed with gram stain and culture; however, newer polymerase chain reaction (PCR) based testing methods are becoming more common.[8] In those who fail initial treatment culture should be done to determine sensitivity to antibiotics.[9] All people who test positive for gonorrhea should be tested for other sexually transmitted diseases such as chlamydia, syphilis and human immunodeficiency virus.[9]

Screening

The United States Preventive Services Task Force recommends screening for gonorrhea in women at increased risk of infection which includes all sexually active women younger than 25 years. It is not recommended in males without symptoms or low risk women.[10]

Prevention

While the only sure way of preventing gonorrhea is abstaining from sexual intercourse, the risk of infection can be reduced significantly by using condoms correctly and by having a mutually monogamous relationship with an uninfected person.[11][12]

Treatment

Penicillin entered mass production in 1944 and revolutionized the treatment of several venereal diseases.

Gonorrhea if left untreated may last for weeks or months with higher risks of complications.[3] As of 2010 injectable ceftriaxone appears to be one of the few effective antibiotics.[9] Because of increasing rates of antibiotic resistance local susceptibility patterns need to be taken into account when deciding on treatment.[9] Many antibiotics that were once effective including penicillin, tetracycline and fluoroquinolones are no longer recommended because of high rates of resistance.[9] Cases of resistance to ceftriaxone have been reported but are still rare.[9][9]

In 2011, there where reports of gonorrhea which had antibiotic resistance to multiple agents, specifically to both cefixime and ceftriaxone.[13][2][14]

Partners

It is recommended that sexual partners be tested and potentially treated.[9] One option for treating sexual partners of people infected is patient-delivered partner therapy (PDPT) which involves providing prescriptions or medications to the person to take to their partner without the health care provider first examining them.[15]

Complications

If not treated gonococcal ophthalmia neonatorum will develop in 28% of infants born to women with gonorrhea.[16]

One of the complication of gonorrhea is systemic dissemination resulting in skin pustules or petechia, septic arthritis, meningitis or endocarditis.[3] This occurs in between 0.6 and 3.0% of women and 0.4 and 0.7% of men.[3]

In men, inflammation of the epididymis (epididymitis); prostate gland (prostatitis) and urethral stricture (urethritis) can result from untreated gonorrhea.[17] In women, the most common result of untreated gonorrhea is pelvic inflammatory disease. Other complications include perihepatitis,[17] a rare complication associated with Fitz-Hugh-Curtis syndrome; septic arthritis in the fingers, wrists, toes, and ankles; septic abortion; chorioamnionitis during pregnancy; neonatal or adult blindness from conjunctivitis; and infertility.

Neonates coming through the birth canal are given erythromycin ointment in the eyes to prevent blindness from infection. The underlying gonorrhea should be treated; if this is done then usually a good prognosis will follow.

Among persons in the United States between 14 and 39 years of age, 46% of people with gonorrheal infection also have chlamydial infection.[18]

Epidemiology

Disability-adjusted life year for gonorrhea per 100,000 inhabitants.
  no data
  ≤10
  10–20
  20–30
  30–40
  40–50
  50–75
  75–100
  100–115
  115–130
  130–145
  145–160
  ≥160
Gonorrhea — Rates: United States, 1941–2007

Gonorrhea is a common infectious disease. In the United Kingdom 196 per 100,000 males 20 to 24 years old, and 133 per 100,000 females 16 to 19 years old were diagnosed in 2005.[3] The CDC estimates that more than 700,000 people in the United States get new gonorrheal infections each year. Only about half of these infections are reported to CDC. In 2004, 330,132 cases of gonorrhea were reported to the CDC. After the implementation of a national gonorrhea control program in the mid-1970s, the national gonorrhea rate declined from 1975 to 1997. After a small increase in 1998, the gonorrhea rate has decreased slightly since 1999. In 2004, the rate of reported gonorrheal infections was 113.5 per 100,000 persons.[19]

In the US, it is the second most common bacterial sexually transmitted infections after chlamydia.[20][21]

History

An old patent medicine named "Gono" pitches itself as "Man's Friend for gonorrhea and gleet – an unequalled remedy for unnatural discharges."

It has been suggested that mercury was used as a treatment for gonorrhea. Surgeons' tools on board the recovered English warship the Mary Rose included a syringe that, according to some, was used to inject the mercury via the urinary meatus into any unfortunate crewman suffering from gonorrhea. The name "the clap", in reference to the disease, is recorded as early as the sixteenth century.[1]

Silver nitrate was one of the widely used drugs in the 19th century, but it became replaced by Protargol. Arthur Eichengrün invented this type of colloidal silver, which was marketed by Bayer from 1897 on. The silver-based treatment was used until the first antibiotics came into use in the 1940s.[22][23]

The exact time of onset of gonorrhea as prevalent disease or epidemic cannot be accurately determined from the historical record. One of the first reliable notations occur in the Acts of the (English) Parliament. In 1161 this body passed a law to reduce the spread of "...the perilous infirmity of burning."[24] The symptoms described are consistent with, but not diagnostic of, gonorrhea. A similar decree was passed by Louis IX in France in 1256, replacing regulation with banishment.[25] Similar symptoms were noted at the siege of Acre[disambiguation needed ] by Crusaders.

Coincidental to, or dependent on, the appearance of a gonorrhea epidemic, several changes occurred in European medieval society. Cities hired public health doctors to treat afflicted patients without right of refusal. Pope Boniface[disambiguation needed ] rescinded the requirement that physicians complete studies for the lower orders of the Catholic priesthood.[citation needed]

Medieval public health physicians in the employ of their cities were required to treat prostitutes infected with the "burning", as well as lepers and other epidemic victims.[26] After Pope Boniface completely secularized the practice of medicine, physicians were more willing to treat a sexually transmitted disease.[citation needed]

References

  1. ^ a b Oxford English Dictionary
  2. ^ a b msnbc, Bad bug: Gonorrhea strain resists all antibiotics. Long-feared development has occurred; only question is whether it will spread, Brian Alexander, msnbc.com contributor, updated 7/11/2011.
  3. ^ a b c d e f g h i Moran JS (2007). "Gonorrhoea". Clin Evid (Online) 2007. PMC 2943790. PMID 19454057. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2943790. 
  4. ^ http://www.gonorrhea-symptoms.com/STD/
  5. ^ Howard Brown Health Center: STI Annual Report, 2009
  6. ^ National Institute of Allergy and Infectious Diseases; National Institutes of Health, Department of Health and Human Services (2001-07-20). "Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention". Hyatt Dulles Airport, Herndon, Virginia. pp14
  7. ^ "webmd – What Can You Catch in Restrooms? -". http://www.webmd.com/balance/features/what-can-you-catch-in-restrooms. 
  8. ^ Barry PM, Klausner JD (March 2009). "The use of cephalosporins for gonorrhea: The impending problem of resistance". Expert Opin Pharmacother 10 (4): 555–77. doi:10.1517/14656560902731993. PMC 2657229. PMID 19284360. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2657229. 
  9. ^ a b c d e f g h Deguchi T, Nakane K, Yasuda M, Maeda S (September 2010). "Emergence and spread of drug resistant Neisseria gonorrhoeae". J. Urol. 184 (3): 851–8; quiz 1235. doi:10.1016/j.juro.2010.04.078. PMID 20643433. 
  10. ^ Meyers D, Wolff T, Gregory K et al. (March 2008). "USPSTF recommendations for STI screening". Am Fam Physician 77 (6): 819–24. PMID 18386598. 
  11. ^ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004526/ section: Prevention
  12. ^ http://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm section: How can gonorrhea be prevented?
  13. ^ Vancouver Sun, Gonorrhea -the latest superbug, Stephen Hume, July 16, 2011.
  14. ^ CDC, Emerging Infectious Diseases, Letter, Ceftriaxone-Resistant Neisseria gonorrhoeae, Japan, Makoto Ohnishi, Takeshi Saika, et al., January 2011.
  15. ^ Expedited Partner Therapy in the Management of Sexually Transmitted Diseases (2 February 2006) U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE. Centers for Disease Control and Prevention National Center for HIV, STD, and TB Prevention
  16. ^ "Prophylaxis for Gonococcal and Chlamydial Ophthalmia Neonatorum in the Canadian Guide to Clinical Preventative Health Care". Public Health Agency of Canada. http://www.phac-aspc.gc.ca/publicat/clinic-clinique/pdf/s1c16e.pdf. 
  17. ^ a b Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier. pp. 705–706 ISBN 978-1-4160-2973-1
  18. ^ Datta, S. D.; Sternberg, M.; Johnson, R. E.; Berman, S.; Papp, J. R.; McQuillan, G.; Weinstock, H. (2007). "Gonorrhea and chlamydia in the United States among persons 14 to 39 years of age, 1999 to 2002". Annals of internal medicine 147 (2): 89–96. PMID 17638719.  edit
  19. ^ "Gonorrhea – CDC Fact Sheet". http://www.cdc.gov/std/Gonorrhea/STDFact-gonorrhea.htm. Retrieved 2008-07-31. 
  20. ^ "CDC – STD Surveillance – Gonorrhea". Archived from the original on 2008-03-06. http://web.archive.org/web/20080306085420/http://www.cdc.gov/std/stats/gonorrhea.htm. Retrieved 2008-08-21. 
  21. ^ "CDC Fact Sheet – Chlamydia". http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm. Retrieved 2008-08-21. 
  22. ^ Max Bender (1898). "Ueber neuere Antigonorrhoica (insbes. Argonin und Protargol)". Archives of Dermatological Research 43 (1): 31–36. doi:10.1007/BF01986890. 
  23. ^ "MedlinePlus – Neonatal Conjunctivitis". http://www.nlm.nih.gov/medlineplus/ency/article/001606.htm. Retrieved 2008-08-28. 
  24. ^ W Sanger. History of Prostitution. NY,Harper, 1910 .
  25. ^ P. LaCroix. The History of Prostitution—Vol. 2. NY,MacMillan, 1931.
  26. ^ WE Leiky. History of European Morals. NY, MacMillan, 1926.


Translations:

Gonorrhea

Top

Dansk (Danish)
n. - gonorre

Nederlands (Dutch)
gonorroe

Français (French)
n. - blennorragie

Deutsch (German)
n. - Gonorrhöe, Tripper

Ελληνική (Greek)
n. - γονόρροια, βλενόρροια

Italiano (Italian)
gonorrea

Português (Portuguese)
n. - gonorréia (f) (Med.)

Русский (Russian)
гонорея

Español (Spanish)
n. - gonorrea

Svenska (Swedish)
n. - gonorré

中文(简体)(Chinese (Simplified))
淋病

中文(繁體)(Chinese (Traditional))
n. - 淋病

한국어 (Korean)
n. - (병) 임질

日本語 (Japanese)
n. - 淋病

العربيه (Arabic)
‏(الاسم) مرض جنسي, السيلان‏

עברית (Hebrew)
n. - ‮זיבה‬


 
 

 

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American Heritage Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.  Read more
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McGraw-Hill Science & Technology Encyclopedia. McGraw-Hill Encyclopedia of Science and Technology. Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved.  Read more
$copyright.smallImage.alttext Gale Encyclopedia of Public Health. Encyclopedia of Public Health. Copyright © 2002 by The Gale Group, Inc. All rights reserved.  Read more
Columbia Encyclopedia. The Columbia Electronic Encyclopedia, Sixth Edition Copyright © 2012, Columbia University Press. Licensed from Columbia University Press. All rights reserved. www.cc.columbia.edu/cu/cup/ Read more
Dictionary of Cultural Literacy: Health. The New Dictionary of Cultural Literacy, Third Edition Edited by E.D. Hirsch, Jr., Joseph F. Kett, and James Trefil. Copyright © 2002 by Houghton Mifflin Company. Published by Houghton Mifflin. All rights reserved.  Read more
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